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General NPI Number Information
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NPI Number | 1417063744
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Entity Type | Individual
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Provider Name | DANIEL KINGSLEY O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 100 N VIRGINIA ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1537
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Country | US
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Telephone | 434-392-8113
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Fax | 434-392-5934
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Provider Business Mailing Address
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Address Line | 12018 W BROAD ST
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City | HENRICO
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State | VA
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Zip | 23233-7796
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Country | US
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Telephone | 804-287-4200
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Fax | 804-364-3379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000544
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License Number State | VA
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